Individual
WILLIAM R WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5885 SUNNYBROOK DR, SUITE L-200, SIOUX CITY, IA 51106-4203
(712) 239-4702
(712) 224-5898
Mailing address
PO BOX 3128, SIOUX CITY, IA 51102-3128
(712) 239-4702
(712) 224-5898
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
16952
NE
207RC0000X
Cardiovascular Disease Physician
1716
SD
207RC0000X
Cardiovascular Disease Physician
Primary
MD-22826
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0192401
—
IA
Enumeration date
02/16/2006
Last updated
10/15/2015
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